Touro University California School of Nursing DNP/FNP...

Rev 080117

Touro University California

School of Nursing

DNP/FNP

Culminating Project

Handbook

DNP/FNP Culminating Project Handbook 2

Introduction

This handbook has been developed to serve as a roadmap to the processes, procedures and

requirements of the DNP Culminating Project. The DNP culminating project is developed,

implemented and disseminated over one-year supported by content delivered across several courses

(Appendix A-C)

Overview of Culminating Project

The DNP program culminates in the successful completion of the scholarly culminating project

that is completed over three semesters. This project is a comprehensive, integrative practice

experience that reflects synthesis of program course work and mastery of expert practice

knowledge in the translation of current research to improve nursing practice or healthcare

outcomes for patients, families, populations or systems. Each student collaborates with an agency

to address a real-world clinical problem or health issue. The project allows the student to

demonstrate clinical expertise and competencies in organizational leadership, system analysis,

program assessment and evaluation and practice change. The student must successfully defend the

capstone in order to complete the requirements for the course and the DNP degree. The final

product of the project is a professional poster, paper presentation and manuscript draft prepared

for publication in a targeted peer-reviewed journal.

Culminating projects can take the form of a/an:

• Evidence-based intervention or change initiative

• Program development and/or evaluation

• Quality improvement initiatives

• Implementation and evaluation of evidence-based practice guidelines

• Design and evaluation of new models of care

• Policy implementation, analysis, revision

A shared feature of these examples is the use of research evidence and systems leadership

to improve healthcare outcomes, whether at the practice, patient, or health system level.

DNP/FNP Culminating Project Handbook 3

Development and Progression of the Capstone Project

Summer

Semester

Session 2

Fall

Semester

Session III &

IV

Spring

Semester

Session VI

Summer

Semester

Session VII

Identify broad interest area X

Identify 5 key articles of interest X

Agency placement X

Culminating Project committee

formation:

Project advisor

Faculty member

Residency mentor

X

Needs assessment for identification of

the challenges/problems leading to the

proposed project.

X

Identify Culminating project: describe

the project and how the project

intervention addresses at least one

challenge/problem that influences

healthcare for a significant number of

persons.

X

Review of the literature

Rating evidence

X

Proposal development X

CITI Training X

IRB Preparation X

Proposal defense X

IRB submission X

Capstone project implementation X

Data/outcome analysis X

Project evaluation (facilitators and

barriers)

X

Dissemination of findings:

Paper turn in

Poster presentation

X

Report development X

Manuscript development X

Capstone defense X

DNP/FNP Culminating Project Handbook 4

Culminating Project Committee

The student is required to submit a culminating project proposal at the completion of the summer

session II. The proposal is written under the direction of the DNP Culminating Project Advisor and

approved by the DNP Capstone Project Committee. The DNP Project Committee will be composed

of three members including the DNP Culminating Project Advisor, DNP Program Coordinator or

designate (DNP faculty member) and the agency mentor or designate. The committee will be

selected once residency placement and mentor have been established.

DNP Culminating Project Advisor

The Culminating Project Advisor will serve as the committee chair and provides academic

guidance and mentoring to the DNP student regarding the capstone project. The student should

meet regularly with the advisor for assistance with project development, implementation, analysis

and dissemination of results. The faculty advisor does not need to be an expert in the student's area

of interest.

Faculty Committee Member

The faculty committee member is a member of the faculty who contributes to the

development and refinement of the capstone project, serves as a paper reader and

participates in defense processes.

Culminating Project Clinical Mentor

Culminating Project Clinical Mentors are advanced clinical practice or administration professionals

who are experts in the students focus area. They facilitate the students meeting of project objectives

and collaborate on the committee. They have an ongoing relationship with students throughout their

clinical hours, contributing especially to the student's development as a leader in the student’s area

of practice. Clinical mentors may be selected from among a variety of disciplines, thereby building

upon the DNP program objective to enhance the student's interdisciplinary experience.

Culminating Project Proposal Defense

The Capstone proposal should be submitted to the committee two weeks prior to the defense

meeting. The student(s) and all committee members must attend the defense in person or via

conference call. The student will provide a 30-minute overview of the proposal. The proposal may

be accepted in full, accepted with major or minor revisions, or rejected. In the case of major

revisions or rejection, the students must develop a revised or new proposal and a subsequent re-

defense meeting scheduled.

DNP/FNP Culminating Project Handbook 5

Once approved, the Capstone Project Approval Form must be signed by all committee members and

placed in the official academic folder. Application for IRB approval should be submitted to Touro

University California IRB. Implementation of the culminating project may begin once IRB

approval is made.

DNP Capstone Proposal Outline

The culminating project proposal should demonstrate evidence of scholarly review and critique

of the literature and a detailed and well thought out project plan.

1. Title Page and Table of Contents

2. Section 1 – Background and Significance (needs assessment, problem statement)

a. Identify specific problem in targeted clinical situation/population

b. Background and significance of problem (define magnitude of problem

in measurable terms; characterize impact of problem on population and/or

organization. Consider bio-psycho-social-cultural-spiritual dimensions.

c. Congruence of needs and organizational strategic plan with project

(market analysis, strategic analysis, readiness for change)

d. Concise problem and purpose statement

e. Project objectives

3. Section 2- Framework

a. Identify and discuss EBP framework for project

b. Identify and discuss organizational theory for project

c. Identify and discuss practice theory for project (if applicable)

4. Section 3- Literature Review

a. Evidence-based literature search and critical appraisal of evidence (leveling

and grading) to support project and interventions

b. (evidence rating may occur at multiple time points in the project)

5. Section 4- Project Design (Evidence Based Project/Intervention Plan)

a. Project Intervention Plan (Procedures)

b. Participants/population

c. Recruitment

d. Data collection instruments

e. Procedures for project implementation

f. Key personnel

g. Stakeholders

h. Potential barriers to implementation and sustainability

i. Ethical considerations

j. Risk-benefits

k. Proposed timeline

DNP/FNP Culminating Project Handbook 6

l. Anticipated Resources Budget

6. Section 5- Evaluation Plan

a. Specific plan for evaluation of each objective

b. Evidence-based measures to be applied to evaluation plan

c. Analysis method for each objective

7. References

8. Appendices

IRB Committee Approval

All projects require approval by the Institutional Review Board through the Touro University

California IRB Committee. Even if human subjects are not involved (ex. data mining, etc.), IRB

approval is necessary since the student is expected to present findings. The student is responsible for

securing IRB approval.

Students are required to successfully pass the CITI certification exam in order to submit a proposal to

the IRB.

Culminating Project Final Report

The final report of the DNP culminating project is a scholarly paper.

The specific format of the paper will be negotiated between the culminating project advisor,

committee members and the student. The final report is to be submitted in electronic and

hardcopy format once recommended revisions are completed. The following is the recommended

format of the report:

1. Title page: Project title, student name and credentials, institution and “in partial

fulfillment of the requirements for the Doctor of Nursing Practice Degree” statement.

2. Signature page

3. Dedication and Acknowledgment pages

4. Abstract

5. Table of contents

6. Background and significance

7. Framework

8. Literature Review

9. Project Implementation

10. Results (specific details of how project was evaluated, method of analysis for each

objective) Objective presentation of findings

11. Discussion – analysis of findings, support with literature, (discussion of facilitators and

barriers, unintended consequences (positive/negative)

DNP/FNP Culminating Project Handbook 7

12. Recommendations and limitations (within framework of strategic plan).

Recommendation for sustaining intervention. Application in other

settings/populations. Limitations of project findings

13. Implications for Practice and Career Development

Contribution of project in achieving DNP Essentials, personal goals

14. References

15. Appendices

Culminating Project Dissemination

The culminating project presentation will be scheduled on the final class meeting for the program.

Candidates will present a poster presentation of the project and a five minute overview of their

findings. The final project must be disseminated to the committee members two weeks before the

project presentation. All committee members must agree that the requirements for the DNP have been

met and that the culminating project is complete and ready to undergo presentation. All members

of the committee are expected to read the project report, forward any clarification questions to the

student and committee at least 72 hours in advance of the scheduled presentat ion . All members are

required to attend the presentation in person or via zoom.

Copies of the project report, with signed project approval form and an electronic copy of the

professional portfolio are submitted to the DNP Culminating Project Advisor prior to graduation.

Guidelines for Internal Review of Scholarly Work

Students seeking to submit their work for any type of external review must seek an internal review

from their capstone advisor. The purpose of this review process is to strengthen the quality of the

work and assist the student's scholarly development. Work that should be reviewed includes:

abstracts for conferences, oral or poster presentations, manuscripts for submission and grant

proposals.

Guidelines for authorship

As a matter of professional integrity, scholars list each major contributor to a work as a coauthor.

Contributions by authors may include conception of the work, writing, data analysis and revision of

the work. Students who are developing a paper or other work for external review should confer

with their capstone advisor before the work begins. Student groups working on a paper or other

project for external review should confer with each other about authorship prior to beginning the

work. These guidelines apply for ideas and papers submitted as part of course work and considered

potentially publishable.

• Authorship may be a complex issue depending on whether the work was the idea of

one person or multiple people and the type of contributions of each person.

• For student work developed with the support of a faculty member, the student will

be first author and the faculty will be listed as second author.

• The order of coauthor's names is important and varies depending on the journal and field of

study. In nursing, the order of author typically signifies the contributions of each author.

The order of authors should be agreed upon before the publication is developed.

DNP/FNP Culminating Project Handbook 8

• Some journals require authors to formally list the role of each author in the

publication and provide guidelines about who should be included as an author based

on their role in the publication.

• Most publications require authors to sign certain assurances about the originality and

contributions of authors to the work presented, and certain laws protecting intellectual

property apply.

Guidelines for acknowledgement

Authors publicly thank those people and organizations that supported the work submitted

for public presentation.

• Prior to acknowledging an organization or person, confer in advance with the

person or organization whose name you intend to publicly recognize.

• Some organizations that provide grant funding will require acknowledgement and

may have a preferred statement about how they wish to be acknowledged.

• Students publishing or presenting their capstone work as sole authors typically

acknowledge the capstone committee and any funding sources.

Professional Portfolio (e-portfolio) The purpose of the Clinical Scholarship Portfolio is to demonstrate achievement of Doctor of Nursing Practice (DNP)/Family Nurse Practitioner (FNP) program outcomes. Clinical experiences will

culminate with portfolio development as a component of the capstone evaluation. Submission of an

acceptable portfolio is a requirement for completion of the DNP program.

Students are responsible for maintaining a log of clinical practicum/residency hours, activities, and

accomplishment of the DNP Essentials. Demonstration of satisfactory progress on the DNP

Essentials is required for progression. In the final semester of residency, the student completes an in-

depth synthesis evaluation of their progress and performance on the DNP Essentials, demonstrating

full and meaningful completion of the Essentials.

The academic professional portfolio will also include:

• Current CV

• Culminating project related documents (IRB etc.)

• Final paper, presentation slides and poster template

Appendix A

Course Number: NRSC

Course: DNP Project Proposal Seminar

Credit: 1 Credit

Placement In Curriculum: Culminating Project – Summer Semester/Session 2

Prerequisites: NRSC DNP Role of Advanced Practice Nursing

NRSC Informing Healthcare Improvement through Data

NRSC Translational Research and Evidenced Based Practice

Course Description:

First in a series of three courses to facilitate the scholarly culminating project. This course focuses on the

development of an evidence-based project proposal for a translational research project. Students will

complete and submit a Touro University California Institutional Review Board (IRB) application.

Emphasis is placed on reviewing the literature and evaluating the evidence using established rating

systems. Prior to completion of this course the proposal will have to be defended and approved by the

student’s Culminating Project Committee.

Outcomes

The student will:

1. Develop an evidence-based project proposal based on problem identification,

needs assessment and comprehensive literature review.

2. Critically appraises and levels the strength of evidence related to an identified

problem.

3. Apply appropriate theoretical frameworks to guide evidence-based practice.

4. Identify potential ethical and legal issues associated with the conduct of EBP.

Appendix B

Course Number: NRSC

Course: DNP Project Management I

Credit: 1 credit

Placement In Curriculum: Culminating Project – Fall Semester/Session 2

Prerequisites: NRSC DNP Role of Advanced Practice Nursing

NRSC Informing Healthcare Improvement through Data

NRSC Translational Research and Evidenced Based Practice

NRSC DNP Project Proposal

Course Description:

Second in a series of three courses to facilitate the scholarly culminating project. This course focuses on

the implementation and evaluation of an evidence based project for translating evidence into practice.

Emphasis is placed on collecting and evaluating data to assess the impact on health care processes and

patient outcomes.

Outcomes

The student will:

1. Discusses strategies to overcome challenges to project implementation.

2. Examines appropriate methods of data analysis based on project goals.

3. Discusses organizational response to change.

4. Explores healthcare policies that promote access, equity, quality and cost.

5. Reflects on advanced practice roles in healthcare organizations and health policy.

Appendix C

Course: DNP Culminating Project Defense

Credit: 1 credit

Placement in Curriculum: Culminating Project – Summer Semester

Prerequisites: NRSC DNP Role of Advanced Practice Nursing

NRSC Informing Healthcare Improvement through Data

NRSC Translational Research and Evidenced Based Practice

NRSC DNP Project Proposal

NRSC DNP Project Management

Course Description:

Third in a series of three courses to facilitate the scholarly capstone project. This course focuses on the

dissemination of findings of an evidence based project for translating evidence into practice. Emphasis is

placed on multiple modalities for disseminating project findings. Students will continue to explore the

various roles of the DNP. Prior to completion of this course the student’s will defend their respective

culminating project before their Culminating Project Committee.

Outcomes

The student will:

1. Evaluate study findings from conclusions and identifies the implications of study

findings for changes in practice, policy, education and future research.

2. Develop an abstract, poster presentation, and podium presentation to disseminate

project findings

3. Develop a written document suitable for manuscript submission.

4. Reflect on advanced practice roles in scholarship and education.

Appendix D Culminating Project Proposal Defense Form

This is to certify that , a

DNP/FNP student in the School of Nursing, has successfully defended his/her culminating project

proposal titled _ and it has been

approved for implementation pending IRB approval.

Culminating Project Advisor ________________________________________Date: _______________

Faculty Committee Member __________________________________________ Date: ________________

Culminating Project Clinical Mentor __________________________________Date:________________

School of Nursing Director___________________________________________Date:________________

Appendix E

Doctor of Nursing Practice Capstone Proposal Rubric

Criteria

Background &

Significance

Describes the phenomena, its importance to healthcare and

affected stakeholders.

Purpose

Statement

Clearly and concisely states the goal of the project.

Review of the

Literature

Provides an organized, integrated summary of the state of

the science (with level of evidence provided).

Theoretical

Framework

Provides appropriate theoretical framework to guide project.

Methods and

Procedures

Clearly and concisely summarizes (where applicable):

• Evidence-based Practice model or Research design

• Participants/population

• Sample/setting

• Recruitment

• Instruments

• Procedures

• Key personnel

• Stakeholders

• Barriers to implementation and sustainability

• Data collection plan

• Data analysis plan

• Ethical considerations

Timeline Provides realistic timeline for project implementation.

Resources Identifies all anticipated resources and potential costs.

Approvals for

Implementation

Identifies required approvals needed for implementation

(cooperating agencies, IRB, etc.)

Evaluation Plan Clearly and concisely summarizes evaluation plan (where

applicable):

Objectives or research questions.

Plan for monitoring objective accomplishment.

Plan if problems encountered during

implementation.

References Current references

Clarity of

Writing and

Writing

Technique

Writing is crisp, clear, and succinct. The writer incorporates

the active voice when appropriate. Appropriate grammar.

APA Follows current APA format guidelines

Appendix F

Doctor of Nursing Practice Culminating Project Paper Rubric

Criteria

Background &

Significance

Describes the phenomena, its importance to healthcare and

affected stakeholders.

Purpose Statement Clearly and concisely states the goal of the project.

Review of the

Literature

Provides an organized, integrated summary of the state of the

science (with level of evidence provided).

Theoretical

Framework

Provides appropriate theoretical framework to guide project.

Methods and

Procedures

Clearly and concisely summarizes (where applicable):

• Evidence-based Practice model or Research design

• Participants/population

• Sample/setting

• Recruitment

• Instruments

• Procedures

• Key personnel

• Stakeholders

• Barriers to implementation and sustainability

• Data collection plan

• Data analysis plan

• Ethical considerations

Resources Identifies all required resources and costs

Approvals for

Implementation

Provides all required letters of support from cooperating

agencies (as appendices).

Results Clearly and concisely summarizes (if appropriate):

• How each goal/research question was objectively evaluated.

• Statistical analyses for each goal/question.

Discussion Addresses each objective:

• Provides facilitators and barriers encountered.

• Identifies unintended consequences (both positive and

negative, if appropriate) and how handled.

• Thorough analysis of findings with comparison to literature.

Recommendations

and Limitations

Provides future recommendations for this project/research

project and possible application of this project in other

settings. Identifies all limitations of project

Implications for

practice and career

development

Discusses impact of project and residency on personal growth

and development.

References Current state of the science references (with table).

Clarity of Writing

and Writing

Technique

Writing is crisp, clear, and succinct. The writer incorporates the

active voice when appropriate. Grammar appropriate

APA Follows APA.

Appendix G Capstone Project Defense Form

This is to certify that , a DNP

student in the School of Nursing, has successfully defended his/her culminating project proposal entitled

and it has been

approved as meeting the requirement for the Degree of Doctor of Nursing Practice.

Oral defense approved Date:

Manuscript approved Date:

Culminating Project Advisor Date

Faculty Committee Member Date

Culminating Project Clinical Mentor Date

School of Nursing Director Date